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Posttraumatic limb shortening: treatment with the Ilizarov distraction device
1Clinic of Traumatology and Orthopaedics, Tartu University Clinics, Estonia. aare.martson@kliinikum.ee
Background And Aims:
Limb length inequality is not only a cosmetic problem, it is also a functional concern. The aim of the study was to analyse the cases of limb lengthening after their posttraumatic shortening. The study design is descriptive and comparative.
Material And Methods:
During the years 1979-1994 14 patients between 4-18 years of age were treated. Limb shortening was the result of premature closure of physeal plate and severe traumas with large bone defects. Ilizarov external devices for limb lengthening were used. The lengthening index was counted. The patients were divided into four groups: minor lengthening, bone transport, femoral lengthening, lengthening with using bone allografting.
Results:
In group I the lengthening index was 29.9 days per centimetre (d/cm), in group II 21.7 d/cm, in group III 33.5 d/cm, in group IV 20.5 d/cm. The complication rate was 28%: 14% "minor" and 14% "major"-stiffness, wound necrosis. None of them affected the final result. In almost all cases the lengthening index was below 30 d/cm.
Conclusions:
The result of limb lengthening is not predictable in every separate case. Multiple lengthening may act on bone regeneration capacity.